who's the ECL?

My photo
Portland, Oregon, United States
I'm not BAD evil, more like devil's food cake evil.

Thursday, July 31, 2008

3. camp at the coast and 10. go to a petting zoo

Two weekends ago I suddenly realised that I had precious little time left to go camping before I go back on call. See, I leave a week early for my sister's wedding, which means I leave in three weeks. Camping spots on the Oregon coast can be hard to find during the summer months; most people start reserving their spots 3 months ahead of time. So in order to find a spot so late in the game, I knew I had to pretty much jump at any chance I got. And there it was, a little opening in the campground schedule between Wednesday and Friday of last week. I looked at my schedule, and it was go. Hooray for not working 40 hour work weeks!

to the south, no sun
cape lookout at low tide

The beach was lovely and beachy--albeit a little overcast and chilly--so on Thursday I took a side trip into Tillamook to visit the cheese factory and go to the petting zoo!

I learned two things about myself while I was in town:

1. Holy crap, I love animals!


2. Holy crap, I love cheese!

I actually spent a good deal of time out at the petting zoo, which is on the property of the Blue Heron Cheese store. I chatted with Llary and Llester, the two llamas I fed. (Those are the names I call them; I don't know what they call each other.) I chatted with the two ponies for quite some time and almost sang them the russian children's song about the pony who wants to be a horse. (It took me a while to remember it.) I watched the pig wallow in the mud, and laughed at the guinea fowl as they puttered about and chirped. I giggled when a rooster crowed, another rooster crowed in response, and then a sheep half-heartedly bleated for effect. (cock a doodle doo! COCK A DOODLE DOO!!!! bah.) Holy crap, I exclaimed to the world, I LOVE ANIMALS!

chewing and observing
everyone, this is llary

Then I went to the Tillamook Cheese factory, bought some ice cream, and watched the cheese packers. So much cheese! So much automation! I became entranced with the rhythm of the process; I found it very soothing. I suppose if it was my job to deal with cheese packing day in and out, I would probably find the rhythm really boring after a while. But for me, as an accompaniment to ice cream eating, it was really great.

oh my gosh--CHEESE!
the rhythm is gonna get you

Then I was back out at the beach, where I walked up and down the shore, read Harry Potter and the Sorceror's Stone, people watched, ocean watched, and generally enjoyed a very relaxing and even slightly boring afternoon.

Harry Potter, year one: I was amazed at all the clues/themes she began in the first book that would eventually play out in book 7. I mean, the wand choosing the wizard concept, Hagrid mentioning he didn't think Voldemort was alive enough to be considered dead, rumours of dragons in Gringott's and how nobody has successfully robbed Gringotts, the introduction of Griphook, how Harry understood--way back then, even though he's angry about it in book 7--that Dumbledore was just giving them enough help for them to figure out things on their own...stuff like that. Kinda blows my mind, how far ahead she was thinking.

The beach. The animals. The cheese. All good times.

Tuesday, July 22, 2008

we saved ginny weasley from the basilisk

yay! joelf and i saw harry and the potters tonight--what a great show. math the band opened for them and they were out of control crazy awesome.

another band that opened for them was uncle monsterface--a live band with sock puppets! here's a photo of me and joelf with uncle monsterface:


i don't have to whine this year!

Saturday, July 19, 2008

20 Baby Products Great for Traumatizing Your Child

Great article from Cracked.com. Click on the whoopee cushion to read. Have some laughs and order the Metallica lullabies for you or a loved one.

Wednesday, July 16, 2008

The Teeth

Holy crap, this is funny.
lotht and found: what’th in the bockth?

POSTED ON Friday, July 11, 2008 AT 08:47 by saint cupcake

are you or is someone you know wandering around without teeth? have you or this someone you know spent anytime in or around the parking lot outside of saint cupcake nw? have you or did someone you know lose some teeth? if you have answered yes to most of these questions, than we might have your teeth.
To find out what the tooth owner's last meal might have been, and learn about the other things people have left there (including a $10,000 check (!), go to St Cupcake's blog.

Aside: I just came back from a lovely weekend in Carmel and Carmel Valley with my sister and 8 of her friends. It was her bachelorette weekend, and it was actually fairly tame (and I am glad)! Carmel is a lovely town, and if it wasn't so freakin expensive, I would be moving there by the end of the year.

Okay, go read about the teeth.

Tuesday, July 08, 2008

Monday, July 07, 2008

Hey AMA, Don't Do It

Don't know if this guy is for real or not, but a well crafted letter in any case.

June 23, 2008

Douglas H. Kirkpatrick, MD
The American College of Obstetricians and Gynecologists
PO Box 96920
Washington, DC 20090-2188

Dear Sir:
I am a practicing OB/ GYN in southern California and Fellow of ACOG and recently was informed by midwife colleagues of your recommendation and encouragement for the AMA to lobby Congress for a law banning out of hospital birth. Funny that I had to hear of this decision from outside sources and was never approached by my college to see how I or my local colleagues felt about it. I have grave concerns regarding my organization taking such a stand. I think we are all agreed that ACOG has a statement regarding patients' rights to informed consent and informed refusal. Yet, it seems with every decision our organization moves further away from that basic tenet. ACOG's little "guideline" paper on VBAC in 2004 where the word readily was changed to immediately has had the chilling effect of doing away with VBAC options at hundreds if not more hospitals. Not due to patient safety, or the ideal of giving true informed consent but really, let's be honest, to fear of litigation. I have seen how patients have become counseled by obstetricians at facilities where VBAC has been banned. They are clearly given a skewed view of the risks of VBAC but rarely told of the risks of multiple surgeries. If you think this is untrue you are, sadly, out of touch with real clinical medicine.

As to out of hospital birthing, please give me the courtesy of an explanation as to the data you used and the process by which an organization which is supposed to represent me came to this conclusion. Any statement saying that it is as simple as patient safety and that one-size fits all hospital birth under the "obstetric model" of practice should be applied to all patients is, putting it nicely, not really in line with what best serves all our patients. In many instances, hospitals are not safe, certainly not nurturing and have a far worse track record for disasters than home birth. Even when emergency help is nearby this is true. The focus of all of us in medicine should be on reigning in trial lawyers and tort reform and lobbying Congress for that. The best interest of the college members and the patients we serve would be for my organization to spend its time and energy on something that has true benefit. Removing choices from well-informed patients and caring doctors and midwives is wholly un-American.

So please send me detailed information on how ACOG decided outlawing home birth was a wise thing to do. You must have scientific data to take such a drastic stand. Please make it available to me so that I may share it with like-minded colleagues. I would also like to know the process by which this came to pass. Who first raised this issue and why? What committee reviewed all the data and did its due diligence in interviewing those of us with long-standing experience in backing midwives who perform out of hospital births. There must be a fine, non-confidential paper trail you can share with your members. Specific names of committee member who voted for this would be enlightening and I am requesting this information. I would like to know the background and expertise regarding out of hospital birth for each member who had a hand in the decision to go to the AMA.

We live in an odd era where once something is said or recommended by a legitimate organization such as ACOG it has deep ramifications never intended such as becoming fodder for trial lawyers trying to squeeze the lifeblood and dignity out of your members. Or forcing women to travel hundreds of miles in labor to find a supportive facility. Or even worse, to have them arrive in a VBAC banned hospital and refuse surgery. Can this be the best we can do for our patients? Remember, your VBAC statement was meant to be only a recommendation but quickly became the rule by which hospital administrators, risk managers and anesthesia departments of smaller hospital banned this option for thousands of women. An option, that in proper hands, was the safe and accepted standard of care for 30 years. In fact, you still have an ACOG VBAC brochure that recommends this option! For those of us working at smaller hospitals where VBAC was banned due to lack of emergency help (anesthesia, OR crews, etc.) there is a big question that has perplexed us that no administrator seems to be willing or able to answer. That question is: "If a hospital cannot handle an emergency c/section for VBACs, and most emergency are for fetal bradycardia, hemorrhage (ie. abruption) or shoulder dystocia not for ruptured uteri, then how can they do obstetrics at all?" For they seem to still be able to have a maternity ward without in house anesthesia. Will someday ACOG, in their great wisdom but seeming disconnect from reality, make a "recommendation" that little hospitals stop providing obstetric services? Will this better serve women and their communities throughout America?

I am frightened and angered by what you have done in my name. Now I ask you to defend your position in encouraging the AMA to lobby Congress for another restriction on the freedom of choice that belongs to women and their families. Those choices include midwifery and the right to have the most beautiful and life changing event occur wherever best fits their desire. Midwives are well trained and required to have obstetrical backup. They have very special relationships with their patients and want the very best outcomes for them. They do not need me or you to police them. We have a habit in our country over the past 40 years of thinking we can legislate out stupidity. All that has done is erode the individual freedoms that belong, by birthright, to each of us. I would hope you trust your Fellows to know their specialty, their colleagues, and what is best for the patient as an individual. These decisions do not belong to politicians or faceless committees. You should have more faith in your members to give balanced informed consent. Again, my recommendation to you is to put all your considerable energy into changing our legal malpractice system. Those of us actually practicing medicine and caring for patients know this to be the greatest threat to the mission and responsibility we have chosen to undertake.

I look forward to your response and possibly the beginning of a meaningful dialogue.

Stuart J. Fischbein, MD FACOG
Medical Advisor, Birth Action Coalition